“I slowed down so much” post-HIV infection – Sexual partnering over time among YMSM of color in the Bronx

Background: YMSM of color in the Bronx, New York, are at increased risk of HIV infection, with 170 new cases reported in this group in 2008.

Methods: We administered a quantitative survey and conducted in-depth interviews with 20 YMSM of color participating in an outreach and retention in care program in the Bronx. We used mixed methods (qualitative and quantitative) to explore YMSM's sexual partnering before and after HIV diagnosis. Results: YMSM of color reported an intense period of sexual activity with multiple partners prior to diagnosis. One youth indicated that he had 35 partners, of which only one “ever said anything about condoms.” Another indicated that after school, “I was like having sex like three times, four times, five times, six times, seven times, eight times like a day, with different partners”, but “slowed down so much” once he was diagnosed. Almost all YMSM indicated that they had less sex post-diagnosis. Only 50% reported >1 partner in the past 3 months, and 90% reported discussing condoms with those partners, although only 75% did so with all their partners during that time period. Eighty percent of participants reported disclosing their HIV status to a partner in the past 3 months, but only 55% had disclosed to all partners. Fifteen percent reported having unprotected sex with at least one partner in the past 3 months.

Conclusions: Results presented here underscore providers' need to explicitly address the sexual partnerships among HIV- and HIV+ YMSM, and to support them in making behavioral changes.